Old age in the technology age / New devices to monitor health and well-being at home a growing new sector

Published 4:00 am, Monday, August 8, 2005

Photo: Michael Maloney

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ELDERTECH08_012_MJM.jpg
Barbara Brown answers the questions posed to her on the Health Buddy.
Health Hero Network, a Mountain View company makes a home monitoring device called Health Buddy. It's a small box with four buttons that plugs into a telephone line and prompts users with a series of questions about their health and well being, plus provides info on nutrition, keeping active etc. The company just got a contract with Medicare to test the device in Oregon and Washington next year (if all goes well, it may become a Medicare option)
Barbara Brown, 73, of San Jose, currently uses the device through an arrangement with the Council on Aging. She has osteoarthritis and says it makes her feel monitored more closely. Photo by Michael Maloney / San Francisco Chronicle MANDATORY CREDIT FOR PHOTOG AND SF CHRONICLE/ -MAGS OUT less

ELDERTECH08_012_MJM.jpg
Barbara Brown answers the questions posed to her on the Health Buddy.
Health Hero Network, a Mountain View company makes a home monitoring device called Health Buddy. It's a small box ... more

Photo: Michael Maloney

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ELDERTECH08
SENSORS TO HELP PEOPLE WITH DEMENTIA
An Intel researcher holds a tiny battery-powered device that wirelessly collects data from sensors embedded in household items such as a floor mat or chair. The device transmits data back to a home PC to alert a caregiver that a patient is trying to stand and leave the room. Credit: intel less

ELDERTECH08
SENSORS TO HELP PEOPLE WITH DEMENTIA
An Intel researcher holds a tiny battery-powered device that wirelessly collects data from sensors embedded in household items such as a floor mat or chair. ... more

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ELDERTECH08_010_MJM.jpg
Health Hero Network, a Mountain View company makes a home monitoring device called Health Buddy. It's a small box with four buttons that plugs into a telephone line and prompts users with a series of questions about their health and well being, plus provides info on nutrition, keeping active etc. The company just got a contract with Medicare to test the device in Oregon and Washington next year (if all goes well, it may become a Medicare option)
Barbara Brown, 73, of San Jose, currently uses the device through an arrangement with the Council on Aging. She has osteoarthritis and says it makes her feel monitored more closely. Photo by Michael Maloney / San Francisco Chronicle MANDATORY CREDIT FOR PHOTOG AND SF CHRONICLE/ -MAGS OUT less

ELDERTECH08_010_MJM.jpg
Health Hero Network, a Mountain View company makes a home monitoring device called Health Buddy. It's a small box with four buttons that plugs into a telephone line and prompts users ... more

Photo: Michael Maloney

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Picture of the MD.2. Photo: Courtesy of Interactive Medical Developments

Picture of the MD.2. Photo: Courtesy of Interactive Medical Developments

Photo: Courtesy Of Interactive Medical

Old age in the technology age / New devices to monitor health and well-being at home a growing new sector

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Talking pill bottles that remind you to take your medicine. A wristwatch that can help find a wandering Alzheimer's patient. Smart Band-Aids that check your temperature and heartbeat. Sensors in bedsheets that monitor sleep apnea and snoring. Motion detectors on doors and furniture that sense when you're up and about, when you stay in bed, and whether you've fallen. Robots that help disabled people get up from a chair and walk down the hall.

They sound like sci-fi, or entries from a Sharper Image catalog circa 2015, but they're technologies that exist today. With the United States' population rapidly aging, electronic devices to monitor seniors' health and well-being at home are a growing new sector. A few are on the market now; more may hit the U.S. market as soon as next year.

"We have the potential to aim our innovation engine at the age wave challenge and change the way we do health care from a crisis-driven, assembly- line, hospital approach to a personal-driven approach, with people taking care of themselves with help from family, friends and technologies," said Eric Dishman, director of health research and innovation for Intel.

The computer-chip giant takes the area so seriously that when it reorganized in January, it created a digital health group as one of its five primary business units reporting directly to the chief executive officer.

"Intel went down this path after a study of 300 households in the United States, South America and Europe where we sent social scientists out to live with and observe them," Dishman said. "We ostensibly focused on digital entertainment, but the overwhelming response by anyone over 40 was, 'I don't need 500 more TV channels; I need a way to manage my diabetes, and more importantly to manage the diabetes of my aging parents.' We heard that so many times, we said: 'We need to start a lab to focus on personal health trends.' "

Now, Dishman leads that lab in Portland, Ore. "We study the needs of seniors and Boomers to figure out how all the gear we're putting into people's lives for digital entertainment can be used for health and wellness," he said.

Although Intel will stick to its mission of building the chips that power products rather than getting into product development itself, the lab has created a number of proof-of-concept devices.

For example, there's a "Caller ID on steroids" for people with memory loss who have become "afraid to answer the phone because they wouldn't know the difference between their own daughter and a stranger calling them," Dishman said. When the phone rings, a screen shows a photograph of the person calling, their name and relationship, and a short summary of a previous conversation.

Like the amped-up Caller ID, many senior tech products are built upon existing devices. That makes them easier for consumers to use, because they are simply extensions of familiar gadgets.

Cell phones, for example, are the basis for a host of ideas for future products, as well as some available now in Europe and Japan.

There is a cell phone that detects voice tremors, indicating a risk of Parkinson's disease. There is one that reminds patients to take their medications at programmed intervals -- and even comes with a built-in pill dispenser. Another has navigational features to help people with memory problems find their way around town; others help monitor conditions like diabetes.

Compelling demographics drive the push to create home health devices for seniors.

As the 77 million Baby Boomers age, there simply won't be enough medical professionals, money or health services to provide personal care for every condition. And even now, many middle-aged people are struggling to care for elderly parents, run their own households and hold down full-time jobs.

Granny-cam raises concerns

Technology is the answer to stretch limited resources and provide better care, proponents say. But it also raises concern that privacy may be infringed and that the loss of personal contact could increase isolation and depression. Then there's the obvious worry about how well it works. The chestnut about a VCR perpetually blinking 12:00 isn't amusing for those who rely on a similarly baffling machine to monitor their blood glucose.

"We've never in history had this much data about the human body," said Elizabeth Boehm, principal analyst for health care and life sciences at Forrester Research in Cambridge, Mass. "How do we store it, make sense of it, who has access to it, who's legally responsible" are all issues that must be thrashed out for what Forrester calls "health care unbound" to take off, she said.

Privacy is a big issue. "Lots of people are concerned about how do you adapt to having your body monitored or your movements monitored," she said.

That's where social engineering, not just technological design, will be key.

"The trick is the individual decides who sees the information being collected," said Russell Bodoff, executive director of the Center for Aging Services Technologies, a coalition of more than 400 companies, universities, health care providers and government entities working on ways technology could help seniors. "Some people push the idea of a video camera, a 'granny-cam.' You will find tremendous (resistance). The idea of your son or daughter being able to turn on a camera and look at you really troubles a lot of people; it would trouble me."

A less-intrusive alternative is motion sensors that send an alert -- via e-mail, pager or phone -- when a person doesn't open the refrigerator door by 9 a.m., for instance. Such systems, which build upon existing home- security products, are already on the market, with more to come.

Cost is obviously a big gating factor.

As with most technologies, senior tech devices are likely to start off pricey and complex and then get more affordable and simpler as products evolve and more consumers buy them.

Keeping track of patients

For example, technology to find wandering Alzheimer's patients, which today costs several thousand dollars and is sold only to law enforcement agencies, soon may be available for under $100 and sold directly to consumers.

Project Lifesaver, which started in 1999 to track wandering Alzheimer's patients using bracelets emitting low-frequency radio signals, costs a couple of thousand dollars for triangulating machines to track signals from the bracelets, which are about $100 each. Law enforcement agencies buy the system and then provide the bracelets to local residents. In Santa Clara County, residents who use Project Lifesaver pay a $25-a-month maintenance fee for the batteries and wristbands.

But a Los Gatos company, Wheels of Zeus, started by Apple Computer co- founder Steve Wozniak, says by next year it will have a complete system of GPS (global positioning system) wristwatches and tracking units for Alzheimer's patients for less than $100 each plus a monthly fee of less than $10. The GPS watches, to be sold by WoZ partners such as a watch company, will also monitor heartbeat and send an alert if it changes.

The biggest cost issue is who pays for "gerontechnology" products. As Forrester's Boehm noted in a report, Americans expect someone else -- an insurer or Medicare -- to pick up the tab for preventive care like immunizations and routine exams -- and rarely make impulse health care purchases. On the other hand, she says, consumers have shown they're willing to pay for treatments like acupuncture and chiropractic even when they're not covered by insurance -- once they're convinced those solutions work.

Medicare is now funding several pilot projects to experiment with new approaches to care, such as Health Buddy, a "telemedicine" device that asks patients with chronic conditions like diabetes about their health and transmits the data to a health care provider (see accompanying story).

Boehm predicts that telemedicine solutions to manage chronic diseases and post-hospitalization issues will prove so cost-effective that insurers and Medicare will start to cover them within the next few years -- partially under pressure from advocacy groups like AARP.

Once that happens, she wrote, "It will take only two to three years from the onset of coverage for cost-conscious consumers and aggressive providers to pounce on newly subsidized services -- and purchase the devices that enable them." That should expand the market quickly.

Devices in use overseas

Elder tech devices have already taken off in Europe and Japan, where the populations are older than in the United States, technologies like cell phones are more advanced and the health care system is sometimes willing to foot the bill.

Japan, for example, has the I-pot, an Internet-connected tea kettle that acts as a safety check for elders living alone. Created by electronics-maker Zojirushi, Fujitsu Corp. and phone giant NTT, it notifies a relative or neighbor what time seniors make their tea -- skipping that daily routine would be a sign of a problem. Japan, a leader in robotics for factories, is considered a good test bed for service robots for seniors to help with mobility and other issues, although such robots are not yet in commercial use.

In Europe, cell phones provide around-the-clock heart monitoring, according to Intel's Dishman. "You wear a sensor that wirelessly relays data to a cell phone, the phone monitors it and sends it back to a doctor, like OnStar (GM's car-safety system) for the body."

Elder-tech proponents say it's important for the United States to maintain a competitive edge in this marketplace. The Center for Aging Services Technologies will sponsor a pavilion showcasing elder-tech devices at the White House Conference on Aging in Washington in December. The president, members of Congress, Cabinet members and 2,000 delegates from across the nation are expected to attend.

Dishman said he hopes the event will help ignite government interest and support for technology for aging in place. For one thing, the United States doesn't have a national institute to fund R&D on senior technology. For another, ultrastrict regulations about product testing and implementation hamper progress.

The U.S. policy that physicians must be licensed on a state-by-state basis -- often an expensive and rigorous procedure -- hinders telemedicine, Dishman said. For example, a patient in Oregon could not be treated remotely by a New York doctor, even if that physician were the country's foremost expert on the patient's disease.

"We have a worldwide demographic crisis," Dishman said. "We can't solve it with (more) doctors and nurses; there aren't enough of them now. We have to figure out how to leverage people's everyday technologies they're comfortable with to use for cajoling them into the right behaviors for good health."

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